The developers of the Wise-Anderson Protocol for pelvic pain have observed that pelvic floor dysfunction has been resistant to medical treatment because of what the authors of the 6th edition of A Headache in the Pelvis called the tension-anxiety-pain-protective guarding cycle. This is a cycle in which chronic tension in the pelvic muscles–typically the result of years of anxiety-related pelvic muscle tightening–has shortened the muscles in the pelvic floor and created an environment in which the pelvic floor can be said to be functioning like a clenched fist. Pelvic pain becomes a physiological alarm to which the body responds with protective bracing and a heightened state of arousal or anxiety. Anxiety produces increased tension, which in turn generates more pain, and which then ratchets up anxiety all over again.

The body’s response of protective bracing, or guarding, is a deeply ingrained part of being human. It is a primitive, instinctive reflex to pull away from that which is threatening or harmful. When someone touches a hot stove, they jerk their hand away; when someone steps on a sharp stone, they begin instinctively withdraw their foot, hopping on the other. It is a functional and important survival mechanism for the body to physically distance itself from the source of pain. Protective guarding is also a central part of muscle-based pain as the reflexive response of protective guarding inside the pelvis exists when someone has discomfort or pain in the pelvis. In describing this pelvic floor protective guarding, David Wise, Ph.D., one of the developers of the Wise-Anderson Protocolexplains that this reaction of protective guarding against pain in the pelvic floor terms out to be a dysfunctional human response for pelvic pain and is central in perpetuating it.

Pelvic pain related to heightened tension in the pelvis is strongly affected and perpetuated by anxiety. Patients who are in chronic pain are understandably emotionally upset about their pain. Indeed, chronic pain and anxiety often go hand-in-hand. Anxiety might manifest as restlessness, irritability, or fatigue. Patients might unconsciously hold their breath, have difficulty sleeping, or find it hard to concentrate. Patients in this kind of pain are caught in the active grip of the tension-anxiety-pain-protective guarding cycle. As a result, the sore contracted pelvis can’t fully relax – a relaxation that is essential to resolution of pain and the healing sore and irritated pelvic tissue.

In the methodology of the Wise-Anderson Protocol, releasing protective pelvic guarding is essential to treating pelvic floor dysfunction. Extended Paradoxical Relaxation (EPR) is the name of the relaxation method used in the Wise-Anderson Protocol for the treatment of pelvic pain, which is presented in 6-day clinics in California.

Developed over twenty years of treating patients with pelvic pain, each session of EPR requires one to four hours to slowly reduce the arousal of an agitated nervous system. The tool’s effectiveness lies in its capacity to help the patient stop chronic moment-to-moment tension that keeps the pelvic floor tight and painful. Along with the physical release of the sore and tightened muscles of the pelvic floor by training patients to do their own internal and external myofascial/trigger point release, EPR helps to break the grip of the tension-anxiety-pain-protective guarding cycle.

First developed between 1995 and 2003 by Dr. David Wise and Dr. Rodney Anderson, with continuing development into the present, the Wise-Anderson Protocol trains pelvic pain patients in self-treatment through a physical therapy with the use of an internal trigger point release device as well as the behavioral program of Extended Paradoxical Relaxation. To learn more about the Wise-Anderson Protocol, visit www.pelvicpainhelp.com.